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Individual
MICHAEL JOHN MARVINNY
Active
Individual
MICHAEL JOHN MARVINNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO26701
OR
208M00000X
Hospitalist Physician
Primary
O-1352
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005953
—
OR
01
—
136209
MEDICARE-TYPE UNSPECIFIED
OR
01
—
838334034
BCBS-ROSEBURG
OR
01
—
838366032
BCBS-MCMINNVILLE
OR
01
—
844477040
BCBS-GRANTS PASS
OR
01
—
858463034
BCBS-MEDFORD
OR
01
—
858464039
BCBS-SPRINGFIELD
OR
01
—
P00400668
RAIL ROAD MEDICARE
OR
Enumeration date
06/22/2006
Last updated
11/18/2021
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